Ensuring good health in the beginning of life sets the foundation for health throughout the lifespan. A healthy childhood is essential to children having the opportunity to thrive and reach their full potential. This chapter includes key indicators of health from infancy through adolescence.
In 7 of the most recent 10 years of available data, Tuolumne County met or exceeded the Healthy People 2020 Goal of 77.9% of pregnant women receiving prenatal care
Births to mothers aged 15 to 19 in California and Tuolumne County have been decreasing (other than in 2013 in Tuolumne County)
Tuolumne County exceeded the Healthy People 2020 National Public Health objective for infant breastfeeding of 81.9% at any time, and has an “any” breastfeeding rate higher than the state average
Most children aged 2 to 11 years in the foothill region see a dentist annually Tuolumne County has shown significant improvements in the number of children meeting fitness standards
Over the past three years, the number of child care slots has reduced on average by approximately 34% each year
Tuolumne County kindergarten immunization rates have been around 75%; this is significantly lower than the state average of 90.4%
Tuolumne County students have lower rates of obesity than the state average but are much higher than the Let’s Get Healthy California 2022 targets of 9% for 0-5 year olds, 8% for 6-11 year olds, and 19% for 12-17 year olds
The current substantiated abuse and neglect rate for Tuolumne County is 19.8 per 1,000 children. The current rate for California is 8.7 per 1,000 children. The 2022 Target for Let’s Get Healthy California is 3.0 per 1,000 children
Tuolumne County students do not vary greatly in meeting the literacy and math standards when compared to the California state average
In all but one year between 2010 and 2014 Tuolumne County exceeded the goal of having 40.5% of foster children achieving permanency within 12 months of entering the system
Tuolumne County students in “non-traditional schools” exhibited higher frequency of substance abuse than those in traditional schools (see definitions)
6% of seventh grade students and 33% of elevenths grade students in traditional schools reported using drugs or alcohol at least once in the past month
Prenatal Care ^
- In 7 of the most recent 10 years of available data, Tuolumne County met or exceeded the Healthy People 2020 Goal of 77.9% of pregnant women receiving prenatal care beginning in the first trimester, defined as the first three months of pregnancy.
- High quality prenatal care can substantially reduce the risk of infant mortality.
- Receiving early prenatal care lowers the risk of adverse birth outcomes, such as low birth weight, developmental delays, and premature birth.
- Women less likely to seek or receive early prenatal care are those with unintended pregnancies. This is most prevalent among younger women, those with limited education and/or those living in poverty.
Births to Adolescent Mothers ^
- Births to white mothers aged 15 to 19 in California have been decreasing, and increased in Tuolumne County in 2013
- Teen birth rates are considered to be a reflection of access and knowledge of family planning methods
- While many teen pregnancies lead to very healthy outcomes, infants of teen mothers face special challenges and statistically require greater social support than infants of mothers over age 20.
- Not only do teen pregnancies have a greater rate of complications during delivery, they also tend to create disadvantages for teen parents, such as lower educational attainment and lower income levels.
- Because there are significant correlations between teen pregnancy rates and ethnicity, it is important to compare Tuolumne County rates to a similar state population, in this case, the White non-Hispanic population of California
- When comparing Tuolumne County’s teen pregnancy rate to a similar population in the state, the county rate is higher
- This suggests knowledge, access, and use of family planning services for Tuolumne County youth is lagging behind the state average
- On a positive note, Tuolumne County schools have been successful in offering student-parents access to education
Breastfeeding Rate ^
- Tuolumne County exceeded the Healthy People 2020 National Public Health objective for newborn breastfeeding of 81.9% at any time, and has an “any” breastfeeding rate higher than the state average.
- Exclusive breastfeeding rate for Tuolumne County has been at or above the state average and above the Healthy People 2020 goal of 46.2%, though in the last year of available data, 2013, the rate has declined to be equal to the state average.
- Tuolumne County may benefit from efforts to raise the rate of exclusive breastfeeding.
We acknowledge that for some women, particularly those who take certain medications, the healthier choice for their children may be to not breastfeed. However, it is well documented that breastfeeding, especially early breastfeeding, has multiple benefits. These benefits include that that breast milk:
- Protects against allergies, sickness, and obesity
- Protects against diseases, like diabetes and cancer
- Protects against infections, like ear infections
- Is easily digested – less constipation, diarrhea or upset stomach
- Over the past three years, the number of child care slots has reduced on average by approximately 34% each year. This has made it extremely difficult for parents to find child care so they can work, go to school, or look for work. Further complexities of finding child care are due to inconvenient locations and/or program schedules that do not meet their needs.
- The majority of the reduction has been the result of the closing of child care centers which represents 32% of the reduced child care slots.
- Weekend and night care is available for only 4% of the estimated number of children needing it
- A child’s experience in his or her early years influences future cognitive development, social adaptation, school readiness, and academic performance.
- A high quality early education experience is linked to a greater likelihood of children completing high school and a decreased likelihood of repeating a grade or being involved in the juvenile justice system.
- Tuolumne County has 3,741 children under the age of 13 with either both parents, the single father or the single mother in the labor force
- Calculations indicate the unmet number of children needing child care is 2,157. However, some families use family members, friends or neighbors to care for their children. Furthermore, some parents choose, out of necessity to work opposite schedules so they are able to offset their need for child care.
Childhood Immunizations ^
- Tuolumne County kindergarten immunization rates have been fairly stable at around 75%; this is significantly lower than the state average of 90.4%.
- Immunizations are successful and cost-effective preventive methods to help millions of children avoid contracting many serious and potentially fatal infectious diseases.
- Children are far more likely to be seriously injured by a vaccine-preventable disease than by the vaccine itself, particularly in an unvaccinated community.
- Tuolumne County schools, both public and private, have had varying levels of accuracy in their reports to the California Department of Public Health.
- Beginning in January 2014, in accordance with Assembly Bill 2109, parents choosing to forego vaccination for their children must receive information about the risks and benefits of vaccination from a health care provider or school nurse. This may have contributed to a small increase in vaccinate rates.
- Senate Bill 277 went into full effect starting July 1, 2016. This bill eliminates the personal belief exemption. It is expected to have a major impact on vaccination rates.
Literacy and Math Achievement ^
- Tuolumne County students do not vary greatly in meeting the literacy and math standards when compared to the California state average.
- Education and literacy, in particular, are highly correlated with health and are considered one of the social determinants of health.
- The World Health Organization recognizes the critical role of literacy in health by listing Primary Education as one of the Millennium Development Goals included in the WHO Global component of health reform that holds great promise for improving the efficiency of our health care system.
- Here we use third grade literacy achievement as an indicator of educational success as it is correlated with academic success and high school graduation.
Dental Care ^
- Most children aged 2 to 11 years in the foothill region see a dentist annually.
- This is important as tooth decay is the most common chronic disease among children ages 6-18.
- Untreated dental problems, such as cavities and gum disease, can affect a child’s health and quality of life by leading to pain, nutritional and sleep problems, impaired concentration, and increased school absences, as well as lost work hours for parents.
Physical Fitness ^
Background and Data
Physical activity is an important aspect of health in children, with many benefits, including:
- Improved heart health
- Increased muscle strength and improved bone health
- Improved weight control
- Decreased risk for many chronic diseases
- Positive effects on mental health
- Inclination to continue healthy lifestyle into adulthood
- Improved education outcomes
Students Who Are Overweight or Obese ^
- Tuolumne County students have lower rates of obesity than the state average but are much higher than the Let’s Get Healthy California 2022 targets of 9% for 0-5 year olds, 8% for 6-11 year olds, and 19% for 12-17 year olds.
- Almost 1/3 of U.S. children are overweight or obese.
- Overweight and obese children are at higher risk for cardiovascular disease, asthma, and some types of cancer, joint and bone problems, sleep apnea, and social and emotional difficulties; they also are more likely to stay overweight or obese as adults.
- California medical care costs related to adult obesity are estimated to be approximately $15 billion.2
Foster Care ^
- In 2015, 80 children entered foster care in Tuolumne County; in all but one year between 2010 and 2014 Tuolumne County exceeded the goal of having 40.5% of foster children achieving permanency within 12 months of entering the system.
- More than one-half of children in foster care had experienced caregiver violence or caregiver incarceration and almost two-thirds had lived with someone with an alcohol or drug problem.
- Adverse Childhood Experiences (ACEs) are traumatic events that occur before the age of 18, and includes the number of survey participants experiencing at least one type of adverse childhood experience.
- Some of the worst health and social problems in our nation can arise as a negative effect of ACEs.
- Given the higher vulnerability of children in foster care, it is important to assess how many children are in foster care and how many are achieving permanency.
Abuse and Neglect ^
- The current substantiated abuse and neglect rate for Tuolumne County is 19.8 per 1,000 children. The current rate for California is 8.7 per 1,000 children. The 2022 Target for Let’s Get Healthy California is 3.0 per 1,000 children.
- Child Maltreatment shows the number of incidents of nonfatal child maltreatment (including physical, psychological, neglect, etc.) per 1,000 children.
- Abuse and neglect has been shown to lead to poor physical and mental health well into adulthood. The long term negative effects of maltreatment include poor developmental outcomes for children such as increased risk for anxiety, depression, and aggressive behavior.
- Abuse and neglect has also been associated with higher levels of child and adolescent obesity and sexual risk-taking as well as poor school performance.
Substance Abuse ^
- Tuolumne County students in “non-traditional schools” exhibited higher frequency of use than those in traditional schools.
- 6% of seventh grade students and 33% of eleventh grade students in traditional schools reported using drugs or alcohol at least once in the past month.
- This was not substantially different than eleventh grade students’ usage.
- As students get older, their use of alcohol and other drugs increases.
- Youth alcohol and/or drug use can be linked to risky health behaviors such as unprotected sex, as well as poor academic performance, physical and/or dating violence, motor vehicle accidents, crime, overdose and suicide attempts.